Objective To investigate the value of virtual reality (VR) technique in the surgical planning for anterior circulation aneurysms of Willis circle. Methods A total of 50 patients with 57 aneurysms confirmed by CT angiography in the anterior circle of Willis were enrolled in this study. In preoperative Hunt-Hess scale, grade I was designated in 7 patients, grade II in 22, grade III in 17, grade IV in 3, grade V in 1 patient. Among the aneurysms, 16 were small (≤5mm in diameter), 28 medium (5-15mm), 10 large (15-25mm) and 3 giant (≥25mm) in size. The thin-slice head scanning data were achieved by 64-slice spiral CT machine. These data was then transferred into Dextroscope image workstation. The virtual imaging system generated clear and vivid virtual images. We compared the findings between simulation surgical operation and actual operation. Results VR system make the operator felt "personally on the scene" and was able to communicate with the imaging. It could not only visually display the anatomical structures in three dimensions, but also could simulate some surgical procedures, which basically simulated the same outcome of actual operation. All the 50 patients were successfully treated by microsurgical clipping of main aneurysmal or contributory aneurysmal necks. Conclusions The surgeons is able to be more confident, and the identification for the complex vascular abnormality is improved by planning operative procedure in virtual-reality environment. The virtual-reality system makes the actual operative procedure more concise, thus it is of positive value in surgery for intracranial aneurysm.

Objective: To investigate the epidemiological characteristics of influenza in Yuhang District, Hangzhou City from 2019 to 2023, so as to provide the reference for formulating influenza prevention and control measures. Methods: Influenza case data with current address in Yuhang District was collected through the Chinese Disease Prevention and Control Information System from 2019 to 2023. Influenza-like illness data was collected through the Hangzhou Epidemiological Investigation System. Time distribution, population distribution and pathogen detection of influenza-like illness were descriptively analyzed. Results: There were 118 319 influenza cases reported in Yuhang District from 2019 to 2023, with an average annual reported incidence rate of 2 316.80/105. The highest incidence rate was seen in 2023, with a reported incidence rate of 5 736.82/105. The peak incidence of influenza occurred from November to March of the following year, presenting the winter and spring epidemic. The cases were mainly distributed in the age groups of 7 to 14 years and 25 to 59 years, with 31 310 and 34 470 cases, accounting for 26.46% and 29.13%, respectively. Influenza cases were reported in all 12 towns (streets) in Yuhang District, with the top two being Wuchang Street and Liangzhu Street, with the average annual incidence rates of 17 346.08/105 and 14 945.80/105, respectively. From 2019 to 2023, there were 103 868 cases of influenza-like illness, and 1 482 throat swab samples were collected. Among them, 260 positive samples of influenza virus were detected, with a positive rate of 17.54%. The peak detection period for positive specimens was from November to March of the following year, with 222 influenza virus positive specimens detected. The influenza virus types included H1N1, H3N2, and Victoria B, accounting for 25.77%, 38.85% and 35.38%, respectively. Conclusions The peak of influenza outbreak in Yuhang District from 2019 to 2023 was in winter and spring, with children and adolescents being the main affected objectives. H1N1, H3N2 and Victoria B were alternately prevalent. Prevention and control measures such as influenza vaccination should be strengthened.

Objective To study the treatment effect of linear accelerator radiosurgery (X knife) on trigeminal neuralgia and the complications. Methods Follow-up was conducted in 42 cases of trigeminal neuralgia treated with linear accelerator radiosurgery in our department, and their complications and degree of pain relief were recorded. Results Outcomes were excellent in 14 (33.3%), good in 22 (52.4%), effective in 4 (9.5%) and poor in 2 (4.8%). The mean time of pain relief was 2.1 months. Seven (16.7%) cases experienced increased facial paresthesia. Conclusion Linear accelerator radiosurgery is a precise and effective treatment for trigeminal neuralgia.

Objective To study the inhibitory effects of troglitazone on the proliferation of rat pituitary adenoma GH3 cell line in vitro and explore the mechanisms. Methods GH3 cells were treated with troglitazone at different concentrations (1×10-7, 1×10-6and 1×10-5 mol/L), dimethyl sulfoxide (DMSO) (DMSO control group) or phenol red- and serum-free F-12 medium (blank control group). MTT assay and flow cytometry was used to detect the cell growth and the cell cycle distribution after the treatment, respectively. Semi-quantitative RT-PCR was performed to detect the expression of cyclin D1 mRNA. Results Troglitazone treatment for 72 h significantly inhibited the cell proliferation and induced obvious G1/S cell cycle arrest and cell death. Compared to those in the blank control and DMSO-treated cells, troglitazone also significantly decreased the expression ofcyclin 1I mR_NA in the GH3 cells in a concentration-dependent manner (P<0.05). Conclusion Troglitazone can obviously inhibit the proliferation of GH3 cells possibly through the mechanism of decreasing cyclin D1 mRNA after its binding to peroxisome proliferator-activated receptor-γ, which induces G1 cell-cycle arrest and promotes cell death.

ObJective To summarize the microsurgieal techniques through direct Sylvian fissure approach. Methods A retrospective analysis was conducted in 62 patients undergoing microsurgeries through direct Sylvian fissure approach, including 4 with cavernous angioma in the Sylvian fissure, 5 with insular lobe tumors, 33 with middle cerebral artery aneurysms, 15 with glioma spanning or invading the Sylvian fissure, 1 with metastatic tumor, 2 with arteriovenous malformations, and 2 with temporal lobe epilepsy. Results All the vascular lesions were exposed satisfactorily and managed appropriately. Of the 19 cases ofgliomas and metastatic tumors, total resection was achieved in 13 cases, and subtotal resection in 6 cases. Transient aphasia or hemiparesis occurred postoperatively in a few patients but all recovered within 1 or two months. Conclusions The Sylvian fissure provides a good surgical route as a subarachnoid space between the frontal, parietal, temporal and insular lobes. The Sylvian fissure should be carefully separated under the operating microscope with high-power magnification, and tension-free retaction is critical in important language areas. In the management of tumors involving the Sylvian fissure, we recommend that extended resection be performed after exposure and appropriate preservation of important blood vessels in the fissure.

Objective To investigate the expressions of intercellular adhesion molecule (ICAM)-1 and matrix metalloproteinase (MMP)-2 in human gliomas and their correlation.Methods Sixty glioma samples,resected in our hospital from March 20,2010 to May 10,2014,were chosen in our study,and corroding to the WHO central nervous system tumor histological grading,they were divided into low-grade glioma group (grade Ⅰ-Ⅱ,n=26) and high-grade glioma group (grade Ⅲ-Ⅳ,n=34);other 10 normal brain tissues were used as controls.Reverse transcription-PCR and SP immumohistochemical staining were used to detect the ICAM-Ⅰ and MMP-2 mRNA and protein expressions.Results (1) The ICAM-1 and MMP-2 mRNA expressions in normal brain tissues,low-grade glioma group and high grade glioma group were increased in sequence,with significant difference (P＜0.05);the positive rate of ICAM-1 protein expression in normal brain tissues,low-grade glioma group and high grade glioma group was 20％,46.1％ and 88.2％,with significant differences (P＜0.05),and that in MMP-2 protein expression was 10％,50％ and 91.1％,with significant differences (P＜0.05).The mRNA expressions ofICAM-1 and MMP-2 in gliomas were positively correlated (r=0.702,P=0.001).Conclusions The expressions of ICAM-1 and MMP-2 are positively related to the malignant degrees of gliomas;the two may be useful reference factors to evaluate prognosis of human gliomas and potential targets for therapy.

OBJECTIVETo investigate the antiviral effect of targeted antisense oligodeoxynucleotides (asODN) in HBV transgenic mice.

METHODSasODN phosphorothioated (5'-CATGCCCCAAAGCCAC-3') targeted to HBV pre-C/C region was synthesized. Gal15-PLL was used as drugs carrier which targeted asODN to mice liver. Twelve mice with positive serum HBsAg, HBV-DNA were divided into the Gal15-PLL-asODN-treated group or the control group randomly. In Gal15-PLL- asODN-treated group, each mouse was injected i.v. asODN 15mug/g weighty/day via tail vein for 12 days successively; while in the control group, each mouse received the same volume normal saline by the same way.

RESULTSIn the Gal15-PLL- asODN-treated group, serum HBsAg decreased at the 6th day (P<0.05), and decreased significantly at the 12th day vs pretreatment (P<0.01). The serum HBV DNA of 4/6 mice became negative. Immunohistochemistry test showed lowered HBsAg, HBcAg content in the liver. In contrast, the control group showed no apparent changes.

CONCLUSIONSGal15-PLL-asODN targeted to pre-C/C region could inhibit HBV replication and gene expression.

Animals ; DNA, Viral ; blood ; Gene Expression ; drug effects ; Hepatitis B Surface Antigens ; blood ; Hepatitis B virus ; drug effects ; genetics ; physiology ; Mice ; Mice, Transgenic ; Oligodeoxyribonucleotides, Antisense ; pharmacology ; Thionucleotides ; pharmacology ; Virus Replication ; drug effects

Objective To discuss the predictive value of magnetic resonance diffusion tensor imaging (MR-DTI) in motor function of patients with tumors in the motor areas of cerebral cortex after surgery on the hemiplegic limbs. Methods Twenty patients with tumors in the motor areas of cerebral cortex,admitted to our hospital from March 2009 to January 2011,were recruited in our study; all these patients underwent MR-DTI and motor function of the hemiplegic limbs was evaluated with Brunnstrom scale before and after the surgery.According to the results of DTI test,the injured corticospinal tract (CST) was divided into 4 grades:type Ⅰ (CST integrity),type Ⅱ (CST integrity with mild compression),type Ⅲ (CST partial disruption) and type Ⅳ (CST mostly/completely disruption).The correlations between the CST damaged level and motor function of the hemiplegic limbs before and after surgery were analyzed. Results FA values ofipsilateral brain parenchyma (0.387±0.012) were statistically lower than those of the contralateral normal brain tissue (0.498±0.015,P＜0.05).No significant differences on CST damaged level and motor function of the hemiplegic limbs were noted between before and after surgery (P＞0.05).CST damaged level and motor function of the hemiplegic limbs had a negative correlation (P＜0.05).Motor function of the hemiplegic limbs and CST damaged level before the surgery and 6 months after the surgery had a significantly negative correlation (before the surgery:r=-0.901,P=0.000; after the surgery:r=-0.912,P=0.000). Conclusion DTI can display damaged level of the tumors in the motor area of cerebral cortex and reflect the motor function of the hemiplegic limbs after the surgery.

OBJECTIVETo compare the efficacy of preemptive epidural analgesia combined with postoperative epidural analgesia, postoperative epidural analgesia alone and intravenous analgesia for postoperative pain relief and their effects on plasma interleukin-6 (IL-6) concentration following radical surgery for gastric carcinoma.

METHODSSixty-six patients with gastric carcinoma scheduled for gastrectomy were randomly divided into 3 groups, namely group P (n=22), group E (n=22) and group V (n=22), to receive preemptive epidural analgesia combined with postoperative epidural analgesia, exclusive postoperative epidural analgesia, and exclusive postoperative intravenous analgesia, respectively. Hemodynamic data were recorded for all the patients during the operation, and visual analogue scale (VAS) was used to assess the pain intensity at 4, 8, 16, 24, 48 and 72 h after surgery. Plasma IL-6 concentration was determined before surgery and at 24, 48, 72 h after surgery.

RESULTSNo significant changes occurred in the hemodynamics during the preoperative periods. VAS and IL-6 were lower in group P than in group E and V, and group E had lower measurement than group V (P<0.05).

CONCLUSIONPreemptive epidural analgesia combined with postoperative epidural analgesia provides more satisfactory pain relief and more effectively prevents IL-6 increment than exclusive epidural analgesia or intravenous analgesia after gastrectomy for gastric carcinoma.

Adult ; Amides ; administration & dosage ; Analgesia, Epidural ; methods ; Analgesics ; administration & dosage ; Female ; Fentanyl ; administration & dosage ; Gastrectomy ; methods ; Humans ; Infusions, Intravenous ; Interleukin-6 ; blood ; Male ; Middle Aged ; Morphine ; administration & dosage ; Pain, Postoperative ; drug therapy ; Stomach Neoplasms ; blood ; surgery ; Treatment Outcome

Objective To explore the diagnosis and treatment strategies of Rathke's cleft cysts (RCC) in the sellar region through analyzing their imaging characteristics.Methods Thirty-two patients with RCC in the sellar region,including two also with concomitant pituitary adenoma,admitted to and performed surgery in our hospital from January 2005 to August 2011,were chosen in our study.The clinical features,especially MRI and histological appearances,were retrospectively reviewed.The experiences on their diagnosis and treatment were summarized.Results Preoperatively,only 3 patients were diagnosed or suspected as RCC.MR images revealed 10 intracystic nodules in 9 patients; their MR signal intensity was variable; not all nodules on T2-weighted images were visualized.Two nodules had bull' s eyelike changes.The hyper-intense content on T1-weighted images was not definitely associated with serious symptoms.Postoperative MRI revealed recurrence or residual lesion in 5 of 26 patients.Conclusion Intracystic nodules with homogenous intensity and non-enhancement under MRI are unique for sellar RCC; Bull's eyelike changes in the intracystic nodule under MRI might have value for confirming the diagnosis.Pituitary inflammation should not be neglected when the clinical symptoms and MRI findings of RCC are being explained.